Fatigue and Quality of Life Following Radiotherapy for Breast Cancer: A Comparative Study

Clinical reports suggest that fatigue is a common and disruptive long-term side effect of radiotherapy; however, there has been little systematic attention given to this phenomenon. The primary aim of this study was to assess fatigue its impact on quality of life in women who had completed radiotherapy for breast cancer. A key feature of this study was the inclusion of a comparison group of women of similar age with no history of cancer. The results indicated that the fatigue experienced by women after radiotherapy for breast cancer was not significantly different in intensity, duration, or disruptiveness from fatigue experienced by healthy women. In addition, radiotherapy recipients reported a quality of life similar to that of the healthy women. For both groups of women greater fatigue was related to a poorer quality of life. These findings suggest that following radiotherapy for breast cancer, women can expect to experience fatigue which is not worse than what they might normally experience. This information may be a useful part of psychoeducational interventions designed for women scheduled to begin radiotherapy for breast cancer.     

Comment on “The Impact of Cancer on Psychological and Social Outcomes (Costa et al., 2016)”

The review written by (Costa et al. 2016) summarises a broad range of topics associated with what is known about the psychosocial outcomes of cancer in patients and their families. This commentary supplements this review by expanding on three topics that were not covered in the review. First, the challenges in assessing and diagnosing anxiety, depression, and distress in cancer patients due to overlapping symptoms with the disease state are highlighted. Second, the contribution of biological pathways such as inflammation upon the genesis and maintenance of anxiety, depression, and distress is acknowledged. Third, the potential role of religion and spirituality in influencing the psychosocial outcomes of cancer is raised. These three points are used to emphasise the importance of firmly incorporating a biopsychosocial model in research and health‐care provisions with cancer patients and their families.     

The Implicit Image of God: God as Reality and Psychological Well‐Being

Research has widely demonstrated that religiosity is related to psychological well‐being even in situations of severe illness. To assess religious beliefs, explicit measures have generally been used. In this study, we measured the belief that God is reality as opposed to myth or abstraction by using an implicit technique (the Single Category Implicit Association Test). The study was carried out in Italy, where a large majority of the population is Catholic, and the prevailing image of God is that of a compassionate and supportive father. Participants were cancer patients identifying themselves as believers. As expected, the automatic belief that God is reality (vs. abstraction) was related to beneficial outcomes: lower reported psychophysical anxiety symptoms and a weaker use of avoidance strategies to cope with stress. Thus, also, automatic religious beliefs may affect feelings and behaviors.     

Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?

Stigma appears to influence emotional distress and well-being in cancer survivors, but cross-cultural differences have been ignored. Previous studies suggest that stigma may be especially relevant for survivors of Asian origin. However, their study designs (e.g. focused on female cancers, qualitative designs, and an absence of comparison groups) limit the strength of this conclusion. We hypothesized that (1) Asian-born Chinese immigrants (AI) would report more perceived cancer-related stigma than Western-born Caucasians (WBC); and (2) the impact of stigma on emotional distress and well-being would be greater in AI as compared to WBC. Head and neck cancer survivors (n = 118 AI and n = 404 WBC) completed measures of well-being, emotional distress, and a three-item indicator of stigma in structured interviews. The majority of respondents (59%) reported one or more indicators of stigma. Stigma correlated significantly with emotional distress (r = .13, p = .004) and well-being (r = ?.09, p = .032). Contrary to our hypotheses, WBCs and AIs did not differ in reported stigma nor did we detect differences in its psychosocial impact. Stigma exerts a deleterious psychosocial impact on head and neck cancer survivors. It did not differ significantly between AI and WBC survivors.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

Healing Faith: A Qualitative Exploration of Latina Breast Cancer Survivors

Latina cancer survivors report higher levels of distress and depression and lower levels of social quality of life and overall health‐related quality of life when compared with all other cancer survivors. Cultural values influence cancer survivorship; however, little research to date has examined how aspects of the Latina culture may be healing during the cancer journey. Therefore, the purpose of this article is to present findings from a qualitative study exploring the influence of culture on quality of life for Latina breast cancer survivors. The authors use consensual qualitative research to understand the lived experiences of Latina breast cancer survivors.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Nodule Detection with Eye Movements

Radiologists often miss nodules that may represent lung cancer on chest radiographs. We investigated whether eye movements collected during the search for lung nodules by large samples of laypeople may provide information that could assist radiologists in their detection. For that purpose, we developed a partially invisible Markov model with partially unobserved states and analyzed eye tracking data of over 100 laypeople who reviewed 14 chest X‐ray images, of which seven contained a potentially cancerous nodule. We used the luminance value of the pixels in the X‐ray images as prior information on the possible location of a nodule and identified six regions of interest on each image that may contain a nodule. Our study demonstrated that the eye movements recorded from laypersons contained information that may assist radiologists in the detection of nodules in chest X‐rays, which has important implications for crowdsourcing of search for pulmonary nodules, which are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

The positive contributions of hope to maintaining and restoring health: An integrative,mixed-method approach

A link between hope and physical well-being has long been suspected. To shed further light on this issue, an integrative theory of hope was used to design three health-related studies. In studies one and two, an integrative hope scale was used. In study one, greater hope was associated with depth of commitment to a healthier diet and regular exercise. In study two, the integrative hope scale was associated with a wider array of health behaviors as compared to a standard goal-oriented hope scale. In study three, a hope-centered content analysis of testimonies provided by long-term breast cancer survivors revealed a strong reliance on attachment and spirituality, dimensions typically neglected in psychological studies of this [hope] construct. An integrative approach to hope offers a framework for further research on hope and health as well as a blueprint for developing positive interventions to sustain and restore physical well-being.     

Who Is at Risk for Psychological Distress in Genetic Testing Programs for Hereditary Cancer Disorders?

Presymptomatic identification of disease gene carriers is becoming an increasingly common part of the clinical management of hereditary cancer disorders. With an expected increase in the number of requests for DNA testing and the limited resources for counseling, the amount of time genetic counselors are able to spend with test candidates will decrease. It is therefore important for counselors to identify persons at risk for psychological distress. Based on a review of experiences with Huntington disease and cancer patients, we describe factors likely to evoke distress in genetic cancer candidates. We also discuss the sometimes widely different ways that test candidates and their partners respond to genetic testing. By exploring risk factors for distress in relevant domains of the research, we can offer counselors guidelines for determining who may need extra counseling.